Ramblings of an Emergency Physician in Texas

‘Meth Mouth’ – New York Times

From the moment on Thursday when the young man sat down in Dr. Richard Stein’s dental chair in southwestern Kansas and opened his mouth, Dr. Stein was certain he recognized the enemy. This had to be the work, he concluded, of methamphetamine, a drug that is leaving its mark, especially in the rural regions of the Midwest and the South, on families, crime rates, economies, legislatures – and teeth.

Every EM doc in the US knows this, by sight (it’s a ‘doorway diagnosis’).

I wrote before about Mothers Against Methamphetamine, and it’s a good site with a good cause. Unfortunately, it’s probably not visited by that many unaffected folks, but is more likely a resource once the drug has damaged someone in the family.

Dear Sir or Madam,
Although “meth mouth” is certainly part of a methamphetamine users problems, it is also a problem to NON USERS, from other kinds of exposures. Besides ?meth mouth? there is a health deterioration problem associated both with methamphetamine use or exposure. I would like to clarify some information which has not yet surfaced but effects many, who are NOT meth users, and never were. These are what are called “inadvertent or innocent exposure victims”. These victims include ‘First Responding officials’ including firemen, police, DEA, and utility workers, and others with special interest who were busting methamphetamine labs.. These people may develop the same classic symptoms of “meth mouth” and health deterioration, yet may have never taken methamphetamine. Also people living in residences where clandestine methamphetamine labs had been, but the residence was not discovered, or was not disclosed to later residents, may also develop the same classic symptoms of ‘meth mouth’ or health deterioration.
Laws governing prosecution of manufacturers forbids taking histories of their former residential labs, if those former residences are not an ‘active lab” at the time of arrest. So many residences are never ‘discovered’. Disclosure laws would allow future renters or owners to be warned a residence was busted, but are not in place in most states.
The problem of residences which are toxic, but undiscovered, or undisclosed is not what it seems at first glance. Most assume a manufacturer is in their first site of manufacturing when they are arrested. This is not true. According to officials involved in clean ups and arrests, manufacturers had been in the ‘business’ for an average of between 6 and 7 years. A grant study in 1986 by Portland Oregon Police and Firemen Risk Management (Funded by DEA and Institute of Criminal Justice) was done to determine if the effects on the teeth and health of their officers was due to their exposure to residential labs (Associate Press release reported Portland Oregon’s ?First Responders? lost teeth, got cancer and died). The answer was, residences used for manufacturing methamphetamine were toxic until cleaned up, exposure can cause illness and dental problems. In Oregon, laws were passed setting up standards of toxicity levels appropriate for future habitation of residences used formerly for manufacturing, and how to clean them up, and disclosure. Oregon also passed laws prohibiting the selling of chemicals which were being used in manufacturing (before 1986), to thwart manufacturing. But these laws had a sad and ironic twist. Manufacturers began manufacturing by a new method, and it made their production quicker. This had the effect that a manufacturer could move as often as every few days to avoid detection. Where as by the older method, manufacturers had to stay put longer to avoid detection, on average moves were every 6 months to a year.
Manufacturers may move every few days for any given year. (thus each could use 100 residences per years)
Most are in business (average) 6 to 7 years. (each could produce 600+ residences per area, before being arrested; 100 X 6)
Most enforcement areas report 30 busts of manufacturing sites per week, per enforcement area. (each week could represent about 18,000 homes per area, made toxic by those arrested; 100 X 6 X 30)
52 weeks per year (each year could represent 930,000 residences per area, made toxic by those arrested; 100 X 6 X 30 X 52)

How do I know these things? I have spent 3 years (since 2002) doing research with EPA and other agencies. Why did I do the research? Our family was had inadvertent innocent exposure, in a rental residence in 1989. We found out about our exposure at 6 months into a year long occupancy. When we moved into the residence (June 1989) there was a strange smell in the residence, however we were assured by the rental agent it was due to the former tenants having had animals, and the residence being shut up in 100+ degree weather for 2 months without air conditioning. The smell was like a diaper pail left for much too long (sour urine and fecal smell), and also like nail polish remover. We installed an evaporative cooler, which blew air out of the home with moisture in it, for a cooling effect. When the weather cooled (late October 1989) I turned off the evaporative cooler. The smell was still present, so the carpet in the most offensive room was removed. The carpet layers found copious amounts of white powder under both the carpet and pad. They said they saw this same thing under many of the carpets they removed. They tasted it and said it was methamphetamine, a street drug, which was being manufactured in residences. They explained to us what methamphetamine was, but not the dangers to our heath. My husband, our 5 kids, and I were often ill while living in that home. We began getting ill within a few weeks of our move into the house, and were ill even after we moved out. Within 2 years of our move out of that house, in February 1992, my husband was diagnosed with cancer, and simultaneously I with Pneumonia, Mononucleosis, Epstein Barr Syndrome and Cyto Meglia Virus (all at the same time). Our children had many odd diseases which did not respond to normal health professional protocols and were unexplained. In March 1992, I called the Federal EPA and Poison Control to ask if there was any correlation of our exposure, to our illnesses. They said no statistics were available correlating the two. In 1994, my husband died of cancer. My children and I have been ill off an on since, although before that rental residence we each enjoyed robust health. In 2002, I read an Associated press release about Portland Oregon’s First Responders who had lost their teeth, gotten cancer and died. I called Federal EPA and Poison Control (July 2002) and told them I had read the Associated Press article and asked if it was accurate, and if there now was statistical evidence of a correlation between exposure and dental deterioration and illnesses. They said yes. I also asked what were our treatment options. They said they did not know. I called the Regional office of the EPA and asked the same questions. They repeated that yes, there was a correlation of illnesses to exposure, but they did not know of treatments. Thus began my research.
Recently in People Magazine (July 8, 2005) innocent/inadvertent exposure victims are featured., v64 16 p50, people who inadvertently lived in former labs (due to absent disclosure laws) and who became ill. As well as web articles of Sheriff, Police and Firemen who became ill from their exposures during busts of meth labs.
Here is the INSULT added to the injury. Inadvertent/innocent exposure may be more common than addiction to methamphetamine, due to the sheer numbers of residences undiscovered or not disclosed as former meth labs (see above). Websites now inform Dentists and health professionals incorrectly that anyone with the ?profile of symptoms? of ?meth mouth? or health deterioration, is GUILTY of having been a user. No other syndromes, illnesses, circumstances are sited for symptoms, although many exist. Many of the websites I visited with these incorrect assumptions, also encouraged citizens to follow and watch ?meth suspects?, which amounts to defamation of character (assumption of use) and stalking (a first degree violent felony).
Methamphetamine is a big, ugly problem. But dentists, health professionals or private citizens taking action by becoming character assassinating, stalking, vigilantes is illegal and immoral.
Thank you,
L.

So far as I know, there’s nothing “Illegal” about making any assumptions, about anything, period.

The fact is, if you show up well dressed and have bad teeth, well, you have bad teeth. If you come to my ED in the clothes you’ve been wearing for the last week, and they don’t fit because you’re losing weight as I watch, you’re covered in tattoos, guess what: I’m going to make an assumption, and I’m going to be right.

Meth Mouth is the correct term. It fits. I’m sorry if you’ve bought a house that had undisclosed problems (welcome to the club) but that doesn’t mean the term is incorrect.